Browsed byTag: Migraine Headaches

A very recent review of prophylaxis of migraine was published in the Canadian Medical Journal (1). To say the least, their findings were remarkable. Although this was a medically oriented review, several herbal and nutritional approaches were rated as effective as drug therapy with significantly fewer reported adverse events. Table 1 is a summary of the findings of the review for interventions when the outcome measure used was the odds ratio of a 50% decrease in frequency of migraine. All findings were based on studies that were graded by the authors as A or B evidence based on the United States Preventive Services Task Force criteria.

Table 1

Intervention

Quality of evidence

Odds ratio of
50% decrease in frequency

Adverse effects

Divalproex

A

2.74

Frequent at higher dosages

Gabapentin

B

4.51

Occasional

Topirmate

A

2.44

Frequent

Amitriptyline

B

2.41

Occasional

Propranolol

B

1.94

Infrequent

Riboflavin (400 mg/day)

A

5.60

Infrequent

Butterbur (50 mg B.I.D)

A

2.24

Infrequent

Pharmaceutical interventions are obviously favored by the medical community even when, at least according to this review, riboflavin and butterbur demonstrate equal or superior effectiveness in A graded studies yet report infrequent adverse effects.

Butterbur: A 2006 systematic review reported on 2 randomized trials (RCT) of butterbur extract (Petasities hybridus) which totaled 293 patients. In these studies a 150 mg dose of butterbur was more effective than a 100 mg dose over a period of 3 to 4 months. Overall butterbur demonstrated a decreased frequency of migraine in over 50% of patients. The brand name of the form of butterbur used in this study was Petadolex (2). In an open label study of 109 children and adolescents the authors found 77% of all patients reported at least a 63% reduction in the frequency of migraine (3). Although no significant adverse effects have been reported in the studies mentioned above, concerns relating to hepatotoxicity have been reported in the literature. A recent study utilizing Petadolex found it to be “free of signals for drug induced liver injury” (3). Several authors have suggested butterbur may be a valuable tool in the prevention of migraine (4-7).

Feverfew: Feverfew is herb that has demonstrated effectiveness in the prevention of migraine in some studies and conflicting results in other studies. Three Cochrane reviews have been published relating to feverfew. The original review could not demonstrate efficacy for feverfew (8) but an update published the same year reported “feverfew is likely to be effective in the prevention of migraine (9). The third review returned to the original position stating “there is insufficient evidence” to suggest an effect (10). A separate article suggested the reason for lack of efficacy reported in the most recent Cochrane review was the 400% variation in the active ingredient in the studies evaluated (5). One RCT published after the Cochrane reviews showed migraine attacks decreased from 4.76 attacks per month to 1.9 when using MIG-99 after 3 months. A dosage of 6.25 mg t.i.d. were used (11). All studies reported a favorable safety profile.

Coenzyme Q10: Coenzyme Q10 has demonstrated efficacy in 1 RCT and several open trial design studies. The RCT was a study of 42 patients. The dosage was 100 mg t.i.d. There was a 50% decrease in headache frequency in 42.6% of the patients in the active treatment group compared to 14.4% in the placebo group after 3 months. The number needed to treat was 3 (12). Another case series found similar benefits using 150mg daily (13). None of the studies on coenzyme Q10 reported adverse effects.

Riboflavin: A RCT compared a combination of riboflavin (400 mg), magnesium (300 mg) and feverfew (100 mg) to 25 mg of riboflavin. Both groups achieved statistically significant improvements over baseline. The authors noted both groups exceeded the normal placebo response reported in other migraine prevention studies. This study suggests a small dose of riboflavin may be an effective prophylaxis for migraine (14). Another RCT using 400 mg daily reported statistically significant improvements in headache frequency and headache days after 3 months. The number needed to treat in this study was 2.3 (15). Unfortunately 2 studies of riboflavin in children did not demonstrate improvement (16;17).

Magnesium: A 2008 RCT examined the prophylactic effect of 600 mg of magnesium citrate daily for 3 months compared to a placebo. Statistically significant improvements in frequency and severity were found in the treatment group. Additionally cortical blood flow increased significantly in the treatment group (18). A second RCT also found a statistically significant decrease in migraine frequency after 3 months using 360/mg per day (19). Not all RCTs have shown magnesium to be of effective. A 1996 RCT found no benefit when using magnesium (20). Soft stools and diarrhea were a common mild adverse event occurring in 18.6% (19) to 47.7% (20) in the magnesium groups.

Most teens experience headaches at some point and many will suffer the debilitating impact of persistent headaches or migraines. Chronic headaches can prevent teens from engaging fully in school, work, and extracurricular activities. Yet little was known about what triggers headaches in teens until now.

A recent study indicated several lifestyle habits associated with migraine and tension headaches in teens. Researchers asked 1, 260 adolescents to fill out a survey on whether they had headaches and if so, the duration and type of headaches they experienced. Participants also responded to questions about their diet and lifestyle including: their physical activity, consumption of alcoholic, nonalcoholic, and coffee beverages, eating patterns, and whether they smoked.

Nearly half of the teen surveyed had tension headaches, 10% had migraines, and 20% had a combination of the two. A considerable amount of participants had unhealthy lifestyle habits like drinking, alcohol and skipping meals. However, 75% had never smoked and 43% didn’t drink coffee.

Researchers found that teens were more likely have migraines if they also drank alcohol, coffee, and/or had low levels of activity. Low physical activity was also associated with tension headaches. Teens that smoked were more likely to have a combination of tension and migraine headaches.

While the study indicates correlation rather than causation, the results do suggest strong links between unhealthy lifestyle and the presence of persistent headaches in adolescents. Researches recommended that further research be done to asses whether educational programs could influence teens’ behavior and experience with headaches. If you’re a teen with persistent headaches or someone you love is, consider consulting with a doctor of chiropractic about healthy lifestyle and nutritional choices that can prevent further pain.

Special Note: One of the best things you can do for headaches is see your chiropractor. Be sure to schedule an appointment with Dr. Oblander if you or your child are having frequent headaches! You can call our office at 406-652-3553.

Headaches are one of the most common types of pain that people experience on a regular basis. Researchers estimate that nine out of ten Americans suffer from headache pain at some point. 95% of women and 90% of men have had at least one in the past 12 months. And for about 45 million of us, those headaches are chronic.

The frequency, severity and duration of headaches can vary greatly from individual to individual. They range from occasional to near-constant and from mild to throbbing. Some are bad enough to cause nausea and become debilitating, preventing the sufferer from working and enjoying day-to-day leisure activities.

What exactly causes headaches?

Headaches occur for many reasons. When they arise on their own (true 90%-95% of the time), they’re referred to as “primary headaches.” When they’re triggered as a result of some other health condition, they’re called “secondary headaches.” Chiropractic physicians most commonly encounter three different types of headaches in their work with patients:

Tension headaches are primary headaches that are brought on by unrelieved muscular contractions in the head, neck and shoulders and/or a misalignment (subluxation) of the neck vertebrae. They’re often the result of stress that cannot find an outlet. Misalignment and muscular contractions can themselves become the source of broader tension and stress throughout the body, setting in motion a feedback loop that eventually produces a headache. According to Dr. George McClelland, a chiropractor in Virginia, “Today, Americans engage in more sedentary activities than they used to, and more hours are spent in one fixed position or posture. This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache.”

Migraine headaches are also primary headaches. They are sometimes referred to as vascular headaches because they happen when blood vessels in the head suddenly expand, or “dilate”. However, we know that the nervous system and genetic factors are also leading contributors. Sufferers report a wide range of triggers and related symptoms. Research into the exact cause of migraines is ongoing, and the condition has stubbornly resisted efforts to find a pharmaceutical “silver bullet”.

Cervicogenic headaches are secondary headaches produced when pain begins in the neck or back of the head and is referred to the forehead or the area behind, in and around the eyes. Trauma, chronic tension and disease are some of the more common initial sources of neck pain that is referred to the head. Trigger points in the neck, shoulder blade and spine may also be sources of these headaches, though they can be much more difficult to identify.

What can be done to relieve headache pain?

While a wide variety of over-the-counter and prescription medications have been developed to relieve this pain, they generally do little to address the underlying cause of the problem. In addition, many of these compounds can have unwanted side effects, particularly if they’re used often, over a prolonged period of time or in combination with other medicines. A growing awareness of both the limitations and risks of pharmaceuticals has led many headache sufferers to explore alternative approaches to managing them, including chiropractic.

A large and growing body of medical research suggests that chiropractic care can be effective in preventing or reducing the frequency and severity of primary headaches. There is also some evidence that it may have benefits for cervicogenic headache sufferers. In a study conducted by the New Zealand government, the majority of those suffering recurrent headaches from spinal misalignment found that their headaches were relieved by chiropractic manipulation, and many were found to still be pain-free in the two-year follow-up. A study published in the Journal of Manipulative and Physiological Therapeutics found that spinal manipulation such as that used by chiropractors is more effective and longer-lasting for treating tension headaches than the use of commonly prescribed pain medication.

A chiropractic physician will perform a thorough examination to identify the cause of your headache pain. Depending on your specific circumstances, he or she may perform chiropractic manipulation or mobilization to improve the alignment of the spine, relieve muscle tension, reduce nerve irritation and improves vascular flow. Massage and other therapies may also be included as part of a well-rounded treatment plan. In many cases, this will relieve headache symptoms. Your chiropractor may also offer posture and lifestyle recommendations to help prevent future headaches. These may involve diet, exercise, sleep and stress management techniques.

Remember—if you or someone you care about suffers from recurring or chronic headaches, there are effective treatment options available that don’t involve drugs. We encourage you to call or visit our office to learn more!

For those of you who wonder if you’ve ever suffered a migraine, it is likely you haven’t. Migraines are a debilitating form of headache that can involve not only intense throbbing head pain, but also nausea, vomiting and flashes of light. Despite how common migraines are, there is surprisingly little known about what exactly causes them. Researchers believe that they are due to a combination of different factors, including genetics and environment, which cause chemical changes in the brain.

When a migraine occurs, levels of serotonin have been found to drop. Serotonin is the neurotransmitter that regulates mood, appetite and sleep. Experts believe this drop causes the trigeminal nerve, which is a major pain pathway, to release neuropeptides into the meninges that covers the brain, causing intense headache pain.

Other likely causes of migraines include the following:

* Hormonal changes in women – Particularly when estrogen fluctuates before menstruation, during pregnancy or during menopause.
* Sensory stimulation – Bright lights, glare from the sun, loud noise or even certain scents (whether pleasant or unpleasant) can trigger a migraine.
* Particular foods – Some of the most common food triggers of migraines are red wine, caffeine, aged cheeses, chocolate and monosodium glutamate (MSG), which is a flavor enhancer commonly used by Asian restaurants. Pickled or fermented foods and the nitrates in deli meats and can also be triggers.
* Not eating – Skipping meals or fasting.
* Changes in sleep – Both getting too much and too little sleep can trigger a migraine.
* Stress – Not surprisingly, stress can contribute to the likelihood of getting a migraine.
* Medications – Particularly vasodilators and contraceptives.
* Physical activity – Intense physical exertion (including sexual activity) can be a trigger.

Your family history plays a major part in whether or not you are likely to get migraines. Of those who suffer from them, 90 percent have a family history of migraine attacks. Although they can begin at any age, most people who are going to get migraines have had their first attack during their teenage years, and nearly all have had at least one by age 40.

Treatment for migraines can include pain relievers such as ibuprofen or acetaminophen and anti-emetics to control nausea and vomiting. For those with chronic migraines who do not respond to over-the-counter pain medication, a doctor may prescribe a drug such as Sumatriptan, which is similar to serotonin and reduces the vascular inflammation that is associated with migraines, in addition to reducing the action of the trigeminal nerve.

In addition to avoiding the known triggers mentioned above, some migraine sufferers use various vitamins and herbal remedies to help prevent them. These include vitamin B12, riboflavin, coenzyme Q10, magnesium citrate, feverfew, butterbur and melatonin.

Chiropractic care can also help to prevent and relieve migraines. Studies have found that chiropractic relieves migraines as well as medication, and with no side effects. Also, those who received regular chiropractic care reported a significant reduction in both the frequency and intensity of their migraines. Dr. Oblander has had great success in working with his patients who suffer from migraines. Quite often, he has discovered that there are multiple factors involved for his patients who frequently suffer from migraines. If you are one of the unlucky ones for whom migraines are a fact of life, just remember that there are safe and effective ways to treat them.

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